LASIK Enhancement: Clinical and Surgical Management

Moshirfar, Majid; Jehangir, Naz; Fenzl, Carlton R.; McCaughey, Michael V

doi:10.3928/1081597x-20161202-01

Cited by 16 publications

(14 citation statements)

References 81 publications

(91 reference statements)

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“…Age-related impairment of central sensory processing is particularly devastating to the elderly as it interferes with their ability to communicate ( Tun et al, 2012 ; Sardone et al, 2019 ), accelerates cognitive decline ( Hewitt, 2017 ), and is linked with Alzheimer’s disease (AD) ( Panza et al, 2015 ). Treatments exist for age-related sensory receptor damage ( Barriga-Rivera et al, 2017 ; Ferguson et al, 2017 ; Higuchi et al, 2017 ; Moshirfar et al, 2017 ). However, there is a stark lack of solutions addressing the co-occurring age-related impairment of central sensory processing ( Humes et al, 2013 ; Humes, 2015 ; Engel-Yeger and Rosenblum, 2017 ; Lesica, 2018 ).…”

Section: Discussion: Translational Applications Of Using Vagus Nerve ...mentioning

confidence: 99%

Rapid Effects of Vagus Nerve Stimulation on Sensory Processing Through Activation of Neuromodulatory Systems

2022

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After sensory information is encoded into neural signals at the periphery, it is processed through multiple brain regions before perception occurs (i.e., sensory processing). Recent work has begun to tease apart how neuromodulatory systems influence sensory processing. Vagus nerve stimulation (VNS) is well-known as an effective and safe method of activating neuromodulatory systems. There is a growing body of studies confirming VNS has immediate effects on sensory processing across multiple sensory modalities. These immediate effects of VNS on sensory processing are distinct from the more well-documented method of inducing lasting neuroplastic changes to the sensory pathways through repeatedly delivering a brief VNS burst paired with a sensory stimulus. Immediate effects occur upon VNS onset, often disappear upon VNS offset, and the modulation is present for all sensory stimuli. Conversely, the neuroplastic effect of pairing sub-second bursts of VNS with a sensory stimulus alters sensory processing only after multiple pairing sessions, this alteration remains after cessation of pairing sessions, and the alteration selectively affects the response properties of neurons encoding the specific paired sensory stimulus. Here, we call attention to the immediate effects VNS has on sensory processing. This review discusses existing studies on this topic, provides an overview of the underlying neuromodulatory systems that likely play a role, and briefly explores the potential translational applications of using VNS to rapidly regulate sensory processing.

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Section: Discussion: Translational Applications Of Using Vagus Nerve ...mentioning

confidence: 99%

Rapid Effects of Vagus Nerve Stimulation on Sensory Processing Through Activation of Neuromodulatory Systems

2022

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“…To date, LASIK is a common corneal surgery for myopia and astigmatism. [ 37 ] It makes the cornea undergo a anatomical change, from its initially prolate shape ( Q < 0) with a steeper central area and flat peripheral area to an oblate shape ( Q > 0) with a flat center and steep periphery. [ 38 – 40 ] LASIK can reduce refractive error and improve uncorrected visual acuity, but several problems still must be resolved regarding postoperative visual function and contrast sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Q-value-guided laser-assisted in situ keratomileusis and standard laser in situ keratomileusis for myopia

Zhang

Fang²,

Yin³

et al. 2020

Medicine

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Background: Previous studies examining the safety and efficacy of Q -value-guided laser-assisted in situ keratomileusis (LASIK) for treating myopia have yielded inconsistent results. We, therefore, performed a meta-analysis to clarify this issue Methods: Various databases were conducted up to November 21, 2018. All randomized controlled trials and cohorts that compared Q -value-guided LASIK with standard LASIK were selected. Mean differences (MDs) or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to evaluate the strength of the correlations. Additionally, different subgroup analyses and publication bias tests were performed. Data were extracted including the number of postoperative uncorrected visual acuity (UCVA) of 20/20 or better, postoperative UCVA, preoperative and postoperative Q -value, postoperative refractive spherical equivalent (SE), the number of postoperative SE within ±0.5D, higher order aberration (HOA), coma-like aberration and spherical-like aberration. Results: A total of seventeen studies with 2640 patients and 3,358 eyes were included. It has been shown that postoperative Q -value (MD = -0.42; 95% CI: -0.64, -0.21; P < .001), HOA (MD = -0.14; 95% CI: -0.23, -0.06; P = .001), spherical-like aberration (MD = -0.19; 95% CI: -0.32, -0.06; P = .004) rather than postoperative UCVA (MD = 0.04; 95% CI: 0.01, 0.07; P = .012) were significantly better in the Q -value-guided LASIK than standard LASIK. However, the pooled results revealed that no significant differences were found between the 2 paired groups of postoperative UCVA of 20/20 or better (OR = 1.09; 95% CI: 0.62, 1.92; P = .763), preoperative Q -value (MD = -0.00; 95% CI: -0.02, 0.02; P = .922), postoperative refractive SE (MD = 0.08; 95% CI: -0.09, 0.25; P = .336), coma-like aberration (horizontal: MD = -0.00; 95% CI: -0.03, 0.03; P = .966; vertical: MD = -0.01; 95% CI: -0.03, 0.01; P = .263) and postoperative SE within ±0.5 D (OR = 1.06; 95% CI: 0.48, 2.33; P = .886). Likewise, similar results were detected in some corresponding subgroups. Conclusion: Q -value-guided LASIK is a safe, effective and predictable surgical option for treating myopia, especially showing superiority over standard LASIK in postoperative Q -value, HOA and spherical-like aberration. However, more detailed studies are required to confirm our conclusions in advanced researches.

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“…Though LASIK is a safe and effective procedure; patients can have residual refractive error afterwards [ 6 , 7 ]. Causes of residual refractive error include under correction, overcorrection, and astigmatism [ 7 ]. Regression refers to the gradual shift of the eye to its original preoperative refraction [ 8 ] and has been reported to occur anywhere from three months to three years after surgery [ 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Laser-Assisted In Situ Keratomileusis (LASIK) Enhancement for Residual Refractive Error after Primary LASIK

Moshirfar

Basharat

Bundogji

et al. 2022

JCM

Self Cite

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Background: To evaluate the safety, efficacy, and predictability of laser-assisted in situ keratomileusis (LASIK) enhancement after primary LASIK and compare to Food and Drug Administration (FDA) criteria. Methods: Patients who underwent LASIK enhancement after primary LASIK between 2002 and 2019 were compared to those who underwent LASIK without retreatment. Patient demographics, preoperative characteristics, visual outcomes, and postoperative complications were compared between groups. Epithelial ingrowth (EI) development was stratified based on duration between primary and secondary procedures. Results: We compared 901 eyes with LASIK enhancement to 1127 eyes without retreatment. Age, sex, surgical eye, sphere, cylinder, and spherical equivalent (SE) were significantly different between groups (p < 0.05). At 12 months post-enhancement, 86% of the eyes had an uncorrected distance visual acuity of 20/20 or better and 93% of eyes were within ±0.50 D of the target. Development of EI (6.1%) demonstrated an odds ratio of 16.3 in the long-term compared to the short-term (95% CI: 5.9 to 45.18; p < 0.0001). Conclusions: Older age at primary LASIK, female sex, right eye, and larger sphere, cylinder and SE were risk factors for enhancement. Risk of EI significantly increased when duration between primary and enhancement procedures exceeded five years. LASIK enhancements produce favorable outcomes and meet FDA benchmarks for safety, efficacy, and predictability.

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LASIK Enhancement: Clinical and Surgical Management

Cited by 16 publications

References 81 publications

Rapid Effects of Vagus Nerve Stimulation on Sensory Processing Through Activation of Neuromodulatory Systems

Rapid Effects of Vagus Nerve Stimulation on Sensory Processing Through Activation of Neuromodulatory Systems

Comparison of Q-value-guided laser-assisted in situ keratomileusis and standard laser in situ keratomileusis for myopia

Laser-Assisted In Situ Keratomileusis (LASIK) Enhancement for Residual Refractive Error after Primary LASIK

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